Validation of claims‐based diagnostic and procedure codes for cardiovascular and gastrointestinal serious adverse events in a commercially‐insured population

Pharmacoepidemiology and Drug Safety - Tập 19 Số 6 - Trang 596-603 - 2010
Peter Wahl1, Keith Rodgers1, Sebastian Schneeweiß2, Brian F. Gage3, Javed Butler4, Charles Wilmer5, Marshall Nash6, Gregory J. Esper4, Norman Gitlin7, Neal Osborn8, Louise J. Short1, Rhonda L. Bohn1
1HealthCore, Inc., Wilmington, DE, USA
2Harvard Medical School, Boston MA, USA
3Washington University-St. Louis, MO, USA.
4Emory University, Atlanta, GA USA
5Piedmont Hospital Atlanta, Ga., USA.
6NeuroStudies.net, Decatur, GA, USA
7Crawford Long Hospital, Atlanta, GA, USA
8Atlanta Gastroenterology Associates, Atlanta, GA, USA

Tóm tắt

AbstractPurposeTo validate administrative claims codes with medical chart review for myocardial infarction (MI), ischemic stroke, and severe upper gastrointestinal (UGI) bleed events in a large, commercially‐insured US population.MethodsThese validation studies were part of a larger study examining the risk of MI, ischemic stroke, and severe UGI bleeds in patients receiving a new prescription of selective cyclooxygenase (COX)‐2 inhibitors (coxibs) and non‐over‐the‐counter (OTC) non‐steroidal anti‐inflammatory drugs (NSAIDs), between 1 July 2002 and 30 September 2004. Patients from the study cohort and other health plan members from the HealthCore Integrated Research DatabaseSM (HIRD) experiencing these events were selected for these studies. The positive predictive value (PPV) of each of the claims code algorithms, using medical chart review as the gold standard, was calculated.ResultsTwo hundred charts per event were abstracted. The PPV for MI was 88.4% (177/200; 95%CI, 83.2–92.5%); PPV for ischemic stroke was 87.4% (175/200; 95%CI, 82.0–91.7%); PPV for severe UGI bleed was 56.5% (109/193; 95%CI, 49.2–63.6%). Refining the ischemic stroke claims algorithm resulted in a PPV of 95.5% (95%CI, 91.0–98.2%); refining the claims algorithm for severe UGI bleed resulted in a PPV of 87.8% (95%CI, 78.7–94.0%).ConclusionThe results suggest that, for certain adverse events, claims data can serve as the basis for pharmacoepidemiology research and drug safety surveillance in the US. Copyright © 2010 John Wiley & Sons, Ltd.

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Thông tin xuất bản

Pharmacoepidemiology and Drug Safety

Tập 19 Số 6

596-603

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